Health systems reform in the quest for universal health

Advancing towards universal health requires resilient and functional health systems based on equitable and sustainable financing and capable of delivering quality, timely and people-centered health services while eliminating direct payments at the point of service. Building such systems is therefore a centerpiece in the quest for universal health. However, this is not an easy undertaking. Strong health systems need appropriate infrastructure, affordable and safe medicines; well-trained professionals, adequate in numbers and distribution; integrated health-care networks; sufficient financial resources; and sound and evidence-based decisions about what services to provide. All this in turn requires sustained political will, strong leadership with clear objectives and goals, regulatory frameworks to ensure the quality and safety of health interventions, and a legal foundation to promote and protect people’s right to health [...] This special issue of the Pan American Journal of Public Health examines Ecuador’s recent experience in health system reform through a series of articles on specific areas that have undergone major transformations as part of the health reform process. It is our hope that this special issue will help Ecuador’s health authorities take stock of their accomplishments and remaining challenges while encouraging health leaders in other countries to implement the changes their health systems need to advance further toward universal health.